Experience and literature suggest that there are systematic differences among different age cohorts of elderly persons, in terms of patterns of factors which bear upon use of long term care institutions during the last days of life. Our aim is to relate the physical, cognitive, and functional status, and support system characteristics of persons 65+ years of age one year prior to death, to the use of institutional care facilities (both acute and long-term) during the last 90 days of life. A parallel study goal is to examine all such factors as they relate to the number of institutional transfers experienced by the elderly during the last 90 days of life. Particular focus will be placed on investigation of possible age cohort differences, i.e., whether or not different patterns of relationships obtain for persons 65-74, 75-84, and 85+, respectively. This information will be important in planning strategies for reducing the characteristically great reliance upon institutions care during the last months of life. With NIA support the applicant already is collecting data which would be used in the proposed study, in relation to a sample of 1,500 elderly decedents who resided in a 14-town area in Southwestern Connecticut. Information is collected during an extensive (45 minute - one hour) structured interview with a person who had the most contact with the deceased during the last year of life. Subjects are selected through a weighted random procedure, based upon the death certificates issued in the 14 town area. The proposed project would make possible the oversampling of old-old, i.e., persons 75+ and, more particularly, 85+ through collection of data from an additional 750 subjects. The current study requires that half of the sample be 75+; however, the truly old-old (85+) are underrepresented in this group. Moreover, the proposed study design requires that subjects not be in long term care one year prior to death; sample augmentation will address this oversampling need, as well. Proposed analyses will include bivariate and multivariate techniques; among the latter, PATH, LISREL, and Logistic Regression are central. Through collaboration with the Social Gerontologic Research Division of the Hebrew Rehabilitation Center for the Aged, data from two additional studies will be included in the analyses, for the purposes of comparison and validation.